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Hea!thNetrr-a
ANNEX 1-c Quotation Request Form
Vendor Name: AU Interested bidders
Deadline: March,31 ,2019 at 11 :00AM local time.
Delivery Date: One week after signing the PO
Delivery Location: HeatthHet TPO Office, Nangahar Regional Hospital, Maraston Square, Dlstrict·l, Jatalabad Afghanistan.
Dear Sir/ Madam,
HealthNet TPO Office
Dehbur1, Deh Naw,Distr1ct 3 Street No.5 House No. 144, kabul www.healthnettpo.org Email:[email protected] Email:[email protected] Ph: 0789BB0790·07B9BB0715 RFQNo. AF298M0·2019-127-KBL
Please send/ provide us with your quotation for the following items below;
tt.e-mNo. Quontlty Unit Procure-ment Item Company I Unit Cost AFN I T-!Cost AFN
1 300 Tab Acetylsalicylic acid (Aspirin) 500mg tab Please provide the quota tion in your c:ompany letterhead, but 2 8000 Tab Activatod charooal &OOmg tab .s tamp i lld ~ i ~;u ll•b RFQ ru•· an:ccphtucc the h:n ns atml
3 200 Amp Adrenalin 1:80000 +Udocaine 2% 2mi(Denatal c.artrige ) conditions.
4 1300 Amp Adrenaline (Epinephrine) 0.1% in 1ml Amp
5 100 Tab Allopurinol 100mg tab
6 6000 Tab Aluminium hydroxide 250mg + Magnesium hydroxide 250mg
7 20000 Tab Amitriptylline 25mg tab
8 20000 Cap Amoxycillin SOOmg Cap
9 6000 Tab Amoxyclllin SOOmg+Ciavulanic acid 125mg (Co~moxiclav) Tab
10 8000 Vial Ampicillin 1g vial
11 3000 Amp Amikacln 1 00mg/ml 1 in 2ml Amp
12 10 VIal Antl-0 Immunoglobulin (Human) 250mcg per dose, In 1 dose Vial (t<hogam)
13 700 Amp Antitetanu l immunoglobulin 15001U/1ml1 in 1ml Amp
14 800 Amp Artemether BOmg/ml,iml, Amp
15 3000 Tab Atenolol SOmg Tab
16 3000 Amp Atropine sulfate 1mg/ml, in 1ml Amp
17 30 Drop Atropine sulfate so lution 0.5% Eye Drop
18 100 Tube Acyclovire ophtamic Sgm
17 ijlj u1~1 W~t ltnltiH t uuiU +NllomYtiH tili~J~. 1•tl1opiUI Ulhl
20 10 "'' Barh_•m sutfate 30% p&renteralaqueous solution
21 30 s,ln.,· Beclomethuon diproplonate 50mcg per dose, nasal spray
22 30 }I.Jf;.lfl Bent:yl benz.oate 2&% in to;nl Bottkt 1 toplul lolion ·- ---·-
:u 111 T.l,. Dww, ~ ... u~ ....... ,l .. 14 (D-.~l ....... u~o ... -. ~ • .- 1.1%1 u ..... ,,~, .. l , ~o.~ .urr .. L ... O .G~)
2~ 500 1"ab Biperiden 2mg Tab
25 20 AmJI Biperiden 5mg/ml 1ml Amp
26 1200 Tab Blucodyl Smg Tab
27 1000 Amp Bupicaine 5mg/ml1 4ml Amp (Spinal heavy)
28 800 Amp calcium Gluconate 10•1., 10ml Amp
ilO 1011 Too~ll ftu iL .. ~u ......... t-11• .. Jftftu,y T.ob
30 16000 VIal Ceftriaxone 1g Vial
31 300 Bot Chloramphenicol 0.5% In In 10 ml bottle, ophthalmic drop
32 1000 c.,) Chloramphenicol 250mg c ap
33 30 Bot Chlorhexldlne Dlg luconate 5% Topical Sol
34 1000 Tab Chloroquine 150mg Tab
35 10 Amp Chloroquinee 40mg/ml, in Sml Amp
36 200 Amp Chlorpheneramine maleate 10mg/ml, in 1m I Amp
37 20000 Tab Chlorpheneramlne maleate 4mg Tab
38 3000 Tab Chlorpromazine 100mg Tab
39 4000 VIal Ciprofloxacin 2mg/ml, fiOml Vial
40 2000 Tab Ciprofloxacln 500mg Tab
41 500 Vial Cloxacillin fiOOmg Vial
42 100 Tab Colchicine O.Smg Tab
43 60 Vial Oeferoxamine Mesylate 50Dmg Vial
44 4000 Tab Diazepam Smg Tab
4 5 8000 Amp Dic lofenac 25mgfml, Jml Amp
46 120 Amp Digoxin 0.25mg/ml, 2ml Amp
41 100 Tab Diphenhydramine chloride 50mg Tab
4 8 4000 Cap Doxycycline 1 OOmg Cap
49 800 Amp Ephedrine Hc13mg/ml, in 10ml Amp
50 5000 Tab Erythromycin Stearate 250mg Tab
51 3000 Tab Erythromycin Stearate 500mg Tab
51 ~~n Amp •n• n• ll'•rina 10DmJ
53 30 liquid Ferrou10 &ulf.ato 125mg/5ml 1 in Oml oral liquid
54 60000 Tab Ferrous sulfate 200mR Tab
55 120000 Tab Ferrous sulfate 60mg +Folic Acid 0.4mg Tab
56 70 Amp Flumazenil 0.1mg/ml, in 10ml Amp
57 13000 Cap Fluoxetine 20mg Cap
58 16000 Tab Folic Acid Smg Tab - -- -59 100 Tab Furazolidone 100mg /' . ~' 6 0 20 Syp Furazolidone 125mg/ 5ml /<
/ . .- -~ ....... · F·,,
6 1 5000 Amp Furosemide 1 Omg/ml1 in 2ml Amp 1 ... / ( :~·~"' • \
6 2 900 Amp Gentamicin Sulfate 10mg/ml, 2ml Amp (20mg/Amp) ,,, /r ., j II I V-"' .,\ 6 3 200 Bot Glucoose 10 % 1 1000miiV infusion +IV set f. ( \ t>) \
64 1700 Bot Glucoose 10 %, SOOmiiV infusion + IV SET I ~~ .n }!'\ ·\ \..., L 65 900 Bot Glucose 25%1 20m I Amp \ \ ') " \'1\ ~~" L.W I I 6 6 5000 Bot Glucose4%+Sodium Chloride 0.18% 1 SOOmiiV infusion+ IV SET \ -·\ - ··' (/) I 67 4000 Bot Glucose 5% 1 1000miiV infusion +IV SET \;...- . I ..... n.--. •''/ I 6 8 2000 Bot Glucose 5% 1 500mi1V infusion + IV SET
\ ~ "' ' / <•/ -~ 69 400 Bot GlucoseS%+ Sodium Chloride 0.9%, 1000mi iV infusion +IV SET "'9 .· '.)-/ £--"" -
70 200 Bot Glucose 50%, 50mi iV _,.- '..._:') . .. _./ _..,. 7 1 200 Tab Glyceryl trinitrate (Nitroglycerine) 0.5mgltab, sublingual-oral Tab ( -- ~ /~~ / 72 10 ,., Glycerin Boric solution 5% ...._ .......... .L:9' [.4 /~ 7 3 3000 Tab Haloperidoi Smg Tab ,JJIJ!l:. ) -fL n. -74 300 Am11 Heparin 50001Uiml1 1ml Amp ., ..wJ 1/f"""l"~ 75 zoo Oint Hydrocortison Acetate 1% 15g Oint I~ .Y"'-' 76 20 Bot Hydrogen peroxide 6% topical Solution L.£::/ ~ ~ 77 600 Tab Hyoscine {butylbromide, hydrobromide) 10mg Tab
r
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80
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82 83
84 85
86 87
88 89
90
91 92
93
94
95 96
97
98 99
100 101
102
103 10~
105
106
107 108
109
110 111
Ill
113 1H 115
116
117
118 119
1LU
Ill 122
123 124
115
127 118
129
nn 131 132
133
134 135
136 137
139
140 111 HZ 143
1H
145
146
147
148
149 150
151 152 153
154
155 156
157 158
159 160 161
162 163
164 165 166
167
168 169
170
200
15000
60
240
100
100
50
1500
300
1500
500
10
200
800
200
600
20
1200
700
500
200
3000
10
600
2000
14500
1300
100
20000
100
1500
1500
200
100
Jijij
500
300
.cooo 2000
11000
soooo 100000
4oU
4000
100
20
1000
800
tOO
2000
'"" 2000
10
100
800
100
800
2000
4000
12000
1000
10
300
100
180
400
9000
5000
13000
30000
200
1200
100
30
1000
100
400
1200
3000
20
10
300
50
12000
12000
20
600
80
100
100
Amp
Tab
Vial
Vial
Cap
Tab
Villi
Vial
Bot
Bot
Bot
Bot
Bot
Bot
Bot
Bot
vi•l
Tab
Tab
Tab
Tab
Amp
Amp
Susp
Tab
Amp
Amp
Tab
Tab
Amp
c.,, Oint
tJrop
Ml ppository
oral
Amp
VIal
Tab
Tab
Amp
T ab
Tab
Bot
Tab
Syr
Tab
Tab
Amp
Tab
Altilt
Tab
Infusion
inluslon
Vl~tl
Vial
Sprny
Bot
Bot
Bot
Tab
Tab
Bot
Amp
Amp
Bot
Bot
Vial
Tab
Amp
Tab
Bot
Drop
Tab
Amp
Amp
Tab
Amp
Vial
Amp
Amp
Tab
Hyoscine (butyl bromide, hydrobromide) 20mg/ml, in 1m I Amp
Ibuprofen 40Dmg Tab
Insulin {70/30) 100IU/ml, 10ml Vial
Insulin {regular) 1001U/ml, 10ml Vial
Iodized Oil 192mg cap
lsosorbide Dinitrate 10mg Tab
lsofloran 100 ml
Ketamin 50mg/ml, 10ml Vial
Ketoconazole 2% 15g Oint
Lidocaine 2% in 15g tube, topical gel
Lidocaine 2% in 50ml Vial
Lugollodin
Lindan
Magnesium Sutfate SOmgfml (50%} 10ml Amp
Mannitol 10%, 500ml infusion
Mannitol 20%, 500ml infusion
Medroxyprogesterone acetate Depot 150mg/ml, in 1ml vial
Mesoprostoi20Dmcg Tab
Metformin 500mg Tab
Methylergometrine 0.2mg Tab
Metoclopramide 10mg Tab
Metoclopramide Smg/ml, in 2ml Amp
Metoprolol1mg/ml, in 5ml Amp
Metronidazoh! 200mg/5ml, in 60ml bottle, Susp
Metronidazole 400mg Tab
Metronldazo._ 5mg/ml, In 100ml bott._, Infusion Sol
Morphine (sutfate,hydrochloride) 10mg/ml, in 1ml Amp
Meglamin antimunate
Multivitamin Tab
Nalidixic acid 500mg
Naloxane 400mcg/ml (0.4mg1ml) In 1ml Amp
Neostigmine Methylsutfate O.Smglml, in 10ml Amp
Nifedipine 20mg Tab/Cap
Nystatin 1DD,ODOIU Ug Vaginal Oint
1'4~stattH 1Utl,OIIUIU JOnlt Ural I d~lt~l Utd~
Nystatin 100,000IU Vaginal Tab/ovule suppo_si_to_ry'------------- ------1------1,--------Nystalin 500,000IU Tab, oral
Omeprazole 20mg Cap
On! I rehyd,.tkm p tb (ORS, Re50m11l • nd k>w OJmolltr) 27.9 1. S.chd:
Oxytocin 101U/mlln 1ml Amp
Paracetamol100my Tab
Paracetamol 500mg Tab
Penicillin tlenzyl (Pen I G cryclt ii 5MU VIal
Penicillin V Potacium soomg Tab
Pethidine 1DOmg Tab
Pethidine 100mg/ml, 1ml Amp
Phtnobarb ltal100mg Tab
Phytomenadione {Vit K) 5mg/ml, 2ml Amp (5Dmg/5ml}
t'buuulllhtl ltidld OUttig lab
Povldone.Jodlne 10% Topical solution 450ml
Prednisolone Smg Tab
Promethazine 25mg/ml 2ml Amp
Promethazine Smg/Sml , in 60ml Syr
Propranoloi40mg Tab
Pyrimethamine 25mg+ Sulfadoxine SDOmg Tab
Propofol amp
Premaqun 15 mg
1ilululuv ~llly~lucliiUil~" 4C~Itly/llll,lu !1111 Alii~
Ranitidine 150mg Tab
Ktnger tactate 1uuum1 IV lntuclon +IV :.~ 1
Ringer lactate 600miiV Infusion t IV SET
R.L,i. iuuuuuuyluLulllua lujat.Uun lOO IUiutllm vial
Anti Rabis vaccin
D.I!Jut.tuvl ltuy/Otul, Itt OOutl Lotti., 011
Salbutamol 0.1mg/dose 200 dose Bottle inhalation
Silver Sulfadiazine 1% Oint (250gr Jar)
Sodium Chloride 0.9% 1000miiV infusion (Nannal Saline} N+ IV SET
Sodium Chloride 0.9% SOOmiiV infusion (Nannal Saline} + IV SET
Sulfmethoxazole lOOmg+Trimethoprim 20mg Tab (Co-Trimoxazole)
Sulfmethoxazole 400mg+Trimethoprim SOmg Tab (Co-Trimoxazole)
Sulphacetamid 20% 10ml Eye Drop
Suxamethonium SOmg/ml 2ml Amp
Stiboglucantime 100mg /ml
Tetracaine 0.5% 15m! Eye Drop / Tetracycline Eye 1% Oint I ~...-Thiopental Sodium SOOmg Vial ..::::- ' ' \ Tramadol100mg Tab I \ Tranexamic acid 50mg/ml, in Sml Amp
Thrihexiphennidyl 2mg Tab
Tropicamide 0.5% 15ml Eye Drop
Timolol solution eye drop 0.5%
Valproic Acid (Sodium Valproate) SOOmg Tab
Verapamil 2.5mg/ml 2ml Amp
Water for injection 10ml Amp \. v ~ / Zinc Sulfate 20mg Tab
( --- ·-------Sodium chloride 5ml
Vancomycin 500mg Amp
Amidaron Amp
Artcsunatc 60 mt: /ml I~ Disprine CV 100 mg --
Ptre toU
L
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198
199
200
201
202 >n~
204
205 101. 207
208
200
210
211
21 2
213
214
215
~H
217
218
219
220
Ann~x 1. N/A
120
200
100
300
30
100
180
20
150
100
500
60
100
100
10
170
200
200
20
200
io 10
400
20
100
100
100
100
100
100
120
1•11 1q
10
lOO onn
10
40
! 0
100
20
20
20
20
20
zo 20
20
20
20
Required documents for the suppll~r qu.~ltflcaUon :
Amp
Amp
Amp
Bot
Amp
Vial
Bottle
Amp
Bot
Amp
Vial
Sol
Amp
oint
MUVial
Am1•
IGt
Kil
Tob
T•b Infusion
Infusion
Amp
Amp
Amp
Amp
Amp
Am11
Amp
VIal
Vhd
Vl•l
"'"' Am11
Am1•
"''' Nebull1.t r
Amp
A"'P
Am1•
Vl11l
Vial
VIal
Vial
Nebulizer
VIol
8 11
Vial
811
Amp
Dobutaminc
Dimcnhydnmate (~ra\inalc:!)
Glyccryl trinitrw.tc {Nitroglycerine) Amp
Kleen Enema 120 ml
Midazolam HCI Smg
Vancomycin lgm
Par-o~ finc liqucd
Iron !IOrbitol with 812 und folic acid
Chlor .. mphenicol 0,5% + Dcxamcthll soncO.I% in tOm I bottle, eye drop
Adenosine Amp
Cdotaximc lg Vial
Fresh frozen plallmll, in SOOml bottle, infusion Sol
P 11ncuronium bromide (Pa\ll lon) lmWml, lml Amp
Polymyxin JOOOOIU+Bacitracin SOOIU per gram, in 6gr tube, ophthalmic oint
Strpokin~ 1.5 MUVial
Vccunmium Bromide 4mg/ml, inlml Amp
Artcmcthcr 40m~ + Lumdantrinc 240m.: Adult Tab
Artcmcthcr 20m~+ Lumdantrinc 120mg Child Tab
Emcll,cncy contraccpth·c Tab (La·on~rel) t .Smg
Riba\·arinc 400mg
Amino ac:id mixture 5% in 500ml infusion Sol
Amino acid mixture 10%, in 500 ml infusion Sol
Adrenaline (Epinephrine) (1 :10000) 0.1% in 1ml Amp
Amiodaron 50mg/3ml
Aminophylline 2Smg/ml, in 10ml Amp
Amikacin 250mg/ml, in 2ml Amp
Artemether 40mg/ml,iml, Amp
Artemether 20mg/ml,lml, Amp
Betamethasone 4mg/1ml Amp
Benzyl Penicilline G SMU V~l
Ceftazldlme 500 mg
Cefotaxime SbOmg vial
Otfi JI Iml lflln1J VII I
Caffe ine 10mg/1ml Amp
Dopamine 40mg/ml, 1ml In 5ml Amp
Jtyarut ORII ORI lii Od iUm I UC.OhtalO 1UUm VIal
lprl troplum bromide 20mac per dote lnh• l• tlon Nebull.r.er
Methylpr.dnoaolone 40mg/ml,ln 2ml Amp
I r.Jut•plnetnllttt .tmynu l N np
Potass ium chloride 10%, 20ml Amp
Prall dox lme 500gm VIal
Benu tloe Penic illin &OOOOOIU Vial
Benu tlne Penic illin 1200000IU Vial
Plperac lllin 2g+ Tazobactam 250mg Vial
Salbutamol respirator Sol nebulizers Smg/ml
s odium Bicarbonate 1.4% (1.4 in 20mi)10ml Vial
Saline 3% in 500ml bottle ophthalmic Drop
Scorp~antivenom In 5ml Vial
Sucra lfate 1g/5ml, In 120m! bottle Sus p
Terbutallne 0.5nlg/ml, In 2ml Amp
The supplf~r has to submit the followlnR documents aloOR with the quotation 1. Business llc~rn:e from Ministry of Commerce or AISA for pharmaceutical Import. 2. Copy of three years relevant contracts. 3.Provfdfng of samples for medlcfnes a..Uoodi_...,._..Wng with quotation is essential. 4GMPCOPP and Qua lity Control nts for drugs are essential.
Oate:25/03/2019
-
-- - -
GRAND TOTAL AFN
Payment: The payment wfll be done 100% afte r the ~ds receipt, inspected , Quality checked and accepted by HNTPO / Tax: 2% tax amount will be deducted from the total cost bf the bid price from re gistered suppliers with AI SA or MOC &. 7% from unreglstered'S'"uppliers as Afghanistan government tax law. Waranty:Supplfers has to provide one year waranty for all items In the RFQ, Penalty: for each delayed day In peformlng the contract odligations a specific penalty which is 0,1% of the total contract value will applied to the supplier's payments. Delivery Location: All goods to be delivered no later than spesified period from the date of signing of purchase order. Pl ease state if goods are available ex-stock or state production timeframe Delivery Time: If the items are not delivered according to the delivery tim e, HNTPO has the rights to cancel the purchase order. and the company wi11 be black-listed with HNTPO for future business. Experience: The company should have at least three years similar exru~riPnc:P ;lnrl thP rnrov nf rnntr<~cts should be ~ubmitted . JI K.u llo~ llll. Til<;: ~r,uuW Will 1.k:i U.:.ll ~ei E:U UlllitH uu,. UllUl~l ll b t U IU lit HN I ~ ~ nniF.ii Nl4HRJMUI" Hllfi.tAIUI HAt~lUI , ~~iitOn !1-Qt.iare, I.Jhtrld 'J ,J:r.lal:r.b:r.d Atgh:r.nM:r.n. lnsp•ction: The c:.oocls will be fn~pcctcd accord In~ to the !peclflcatlon by lltfTPO t~hnlcal team. Bid Validity: The bid must be valid for 30 days from the submission date: Submission Procedur~: Please fill the above RFQ, sf1;1n and stamp ft for final submission to HNTPO office before the deadline. Accountability: All the bid documents must be stamped and s i~ned by the authorized representative of the company. Currency: The bid must be QUOted In Afs;(han Currency. RIRhts: HNTPO has the ri~ht to Increase , decrease the quantity . Packing: All goods must be packed for suitable air/sea or road transportation including rough handling to final destination Marking: All the bo)(es must be marked with HealthNetTPO delivery address language:AII documents, markings and labeling should appear in English.
NOTE: This is to certify by the supplier that the above terms and conditions are acceptable to us and we have no objection.
Submitted by: Name=----------------------------------------------------------
SiQ.nature: ----------------------------------------------------------
Stamp:
P•cc Joi J
Position:---------------------------
Date:-----------------------------